1095-B - HRS3880

Personnel > Maintenance > ACA 1095 YTD Data > 1095-B

This tab allows you to manually input and track employee and covered individual year-to-date health coverage data.

Notes:

You can import records by uploading a comma-delimited text (.txt) file using the Utilities > Import ACA 1095-B/1095-C Data page.
For employees with a self-insured insurance plan, you can extract insurance data from the Maintenance > Staff Demo > Insurance tab to this page by using the Utilities > Extract Insurance Data to 1095 Data utility.
For more information about Form 1095-B, click here and refer to the Instructions for Form 1095-B.

Enter 1095-B data:

Field	Description
Calendar Year	Populated with the current calendar year; however, you can enter a different year. The year must be greater than or equal to 2015.
Employee	Begin typing the employee name or number. As you type the data, a drop-down list of corresponding data is displayed. Select an employee and click Retrieve. Or, click Directory to perform a search in the Employees directory. Note: The employee autosuggest field includes employees whose records were created in Personnel but do not have a Pay Info or Job Info record.
Coverage Type	Select the coverage type (i.e., origin of policy) in which the employee is enrolled. A - Small business health options program (SHOP) B - Employer-sponsored coverage C - Government-sponsored program D - Individual market insurance E - Multiemployer plan F - Miscellaneous minimum essential coverage

❏ Under Covered Individuals, complete the following fields for each covered individual:

First Name	Type the covered individual’s first name. The field is 17 characters.
Middle Name	Type the covered individual’s middle name. The field is 14 characters.
Last Name	Type the covered individual’s last name. The field is 25 characters.
Generation	Click to select the covered individual’s generation code.
SSN	Type the covered individual’s nine-digit social security number. Form revision per 2016 IRS guidelines, effective for the 2016 tax year: In the SSN or Other TIN field, type the covered individual’s nine-digit social security number or other taxpayer identification number.
DOB	Type the covered individual’s date of birth in the MMDDYYYY format. Or, select a date from the calendar. Form revision per 2016 IRS guidelines, effective for the 2016 tax year: In the DOB (If SSN or other TIN is not available) field, type the covered individual's date of birth in the MMDDYYYY format only if the SSN or other TIN field is blank.
All	Select to indicate that the individual was covered for at least one day per month for all 12 months of the calendar year. Or, if the individual was not covered for all months, select the applicable month (Jan-Dec) fields in which the individual was covered for at least one day during the month.

❏ Click Save.

	Click to delete a row. The row is shaded red to indicate that it will be deleted when the record is saved. Click Save.
Delete	Click to delete the entire record.

Business